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Comorbidities. • Ethnic group. Treatment. Availability. Laws. Attitudes. Page 41. It is better to know some of the questions than all of the answers. James Thurber.
What is the impact of gambling availability on gambling problems? David Hodgins AGRI, 2006

What is the impact of gambling availability on gambling problems? Three models „ Linear Problems

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none

some

a lot

many

Gambling availability

tons

Saturation Model

Problems

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none

some

a lot

many

Gambling availability

tons

Social Adaptation Model (Shaffer)

Gambling availability

to ns

m an y

lo t a

so m e

no ne

Problems

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Challenges to testing the models •

Operationalizing Terms



Confounding Factors

Operationalizing Terms „

Different ways of conceptualizing Gambling Availability /accessibility /exposure 1. Dichotomous (yes/no) „ Lester (1994) US states with and without casinos – # of GA groups „ E.g., before and after opening a casino

2. Number of different available types of gambling „ Volberg (1994) – cross sectional comparison of states

Conceptualizing Gambling Availability /accessibility /exposure (cont) 1.

Dichotomous (yes/no)

2.

Number of different available types of gambling

3.

Shaffer’s proposed Regional Index of Gambling Exposure „ „

Uses environmental exposure to chemical toxins as model (Shaffer et al., 2004) Three summed components „ „ „

Dose (D)– quantity of gambling Potency (P)– number of types of gambling Duration (T) – years of exposure

RIGE = D + P+ T „Dose (D)– quantity of gambling # of gambling establishments # of people employed in casinos and casino hotels

„Potency (P)– number of types of gambling # of legal forms of gambling available (of 6)

„Duration (T) – years of exposure Years of legalized gambling in state

RIGE and Gambling ProblemsNevada (adapted from Shaffer et al., 2004)

Problems with RIGE „ „

Equal weighting of factors Inclusion of # of employees? „ „ „

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More validation research „ „

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Alberta 10% of household $, four times higher) „

Other Research Gambling Availability

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Gambling Behaviour

Gambling Problems

UK Studies – National Lottery 1994 (Shepherd et al., 1998) Resident mail questionnaire Oct-94, May-95 andNov-95 (N=206, 38%) „ Increase in gambling DSM symptoms; (17% increase in calls to GA) „

Other Research Gambling Availability

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Gambling Behaviour

Gambling Problems

Canadian Studies – opening casinos Windsor (Govoni et al., 1999) „ RDD survey (SOGS) 1993 (N=1682), 1995 (N=2581), 1997 (N=2714) „ Increase in number gambling after 4 years, but not number of problem gamblers „

Canadian Studies – casinos Gambling Availability

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Gambling Behaviour

Gambling Problems

Niagara (Room et al., 1999) RDD 1996 Niagara Falls residents (N=677) and followed for 1 year (69%) plus other databases „ short SOGS „ Increase in gambling, increase in problems, increase in knowing someone with problem „

Canadian Studies – casinos Gambling Availability

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Gambling Behaviour

Gambling Problems

Gatineau (Jacques et al., 2000) 1996 RDD in Gatineau (N= 810) and Quebec City (control, N=798) followed for one year (79% and 73%) „ SOGS „ Increase in gambling, increase in problem but not pathological gambling, increase in knowing someone with problem „

Summary of Longitudinal Research

Gambling Availability

Gambling Behaviour

• All short term follow-ups • Future studies?

Gambling Problems

Laws

Gambling Availability

Attitudes

Gambling Behaviour

Treatment Availability

Gambling Problems

Vulnerability Factors • Age • SES • Comorbidities • Ethnic group

Treatment Seeking

It is better to know some of the questions than all of the answers James Thurber